AIDS pioneer helped analyze blood, confirm that toddler has been cured of infection

The startling finding that it may be possible to cure HIV infection in babies was confirmed, in part, by a UC San Diego researcher who has helped direct the war against the virus since AIDS emerged as a global health threat in the 1980s.

Dr. Douglas Richman said he worked with a team of East Coast researchers last fall to analyze blood samples for traces of HIV from the Mississippi toddler who appeared to have been “functionally cured” of the virus.

Richman said he used sensitive equipment that separated the blood samples into thousands of tiny droplets in order to perform the HIV analysis, which doctors call an assay.

“We basically helped do assays to confirm that there was no detectable (replicating) virus in the baby,” Richman said Monday, speaking from the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta.

Those findings helped lead to Sunday’s announcement at the same conference that scientists had effectively cured the unnamed girl of HIV infection by giving her of high doses of three common antiretroviral drugs within 30 hours of her birth. The toddler was born in July 2010 and continued taking the drugs for 18 months. She then went off the medication, but the virus has not emerged in her bloodstream, suggesting a path forward in curing other babies.

The advance, if confirmed by additional tests, would be among the biggest discoveries in the history of the battle against HIV, an infection carried by at least 34 million people worldwide.

Richman has been an influential figure in the fight. He helped show that the virus can remain latent for very long periods, a discovery that helped researchers who were developing drugs to fight the disease. The discovery also convinced many people to be tested for the virus.

Richman also has made key findings about the evolution of HIV and pointed out ways that the immune system mounts a response to the infection. These contributions aided in the creation of the powerful “cocktail” of drugs that’s now routinely given to people with HIV.

Richman and other UC San Diego scientists continue to search for ways to overcome the bits of HIV hiding in the immune system itself, which are the main obstacle to finding a cure.

Speaking by telephone from Atlanta where the breakthrough was announced, Richman noted that while the results concern only one patient and will need to be replicated in others, they are still encouraging.

“This may prompt some new approaches to diagnosis and treatment in kids. We’ll see,” he said.

Another local HIV research pioneer, Dr. Flossie Wong-Staal, agreed that the work is promising.

“This is a very exciting first example, but we need more information. We need to know, for example, if it can be replicated,” said Wong-Staal, who was a UCSD researcher and now works for iTherX Pharmaceuticals, a private company in San Diego.

In the early 1980s, Wong-Staal was the first to clone HIV and determine its genetic makeup. Her work is seen as a major step in understanding the way the virus worked, which in turn led to the antiretroviral drugs used today.

Both Wong-Staal and Richman noted that the quick-treatment method used with the Mississippi toddler likely will have less value for adults, because detection for them usually does not occur until symptoms present themselves. Symptoms do not usually arrive, Richman said, until long after the virus has had time to build a reservoir of latent copies.

“With adults, it’s really hard to find people within days of infection,” Richman said.

The doctor’s current research continues to explore HIV resistance and immune response, following local patients who are acutely infected, looking for a way to permanently drain the reservoirs that his work detected more than 20 years ago.

“The really big effort is trying to figure out how to find treatments that can help purge the immune system of the virus,” Richman said.